Pamela Schaff

Being the best we can be: medical students' reflections on physician responsibility in the social media era.

Purpose To examine attitudes, self-reported behaviors, and intended actions related to medical students’ use of online social media after an educational intervention. Method In 2011, 180 first-year medical students at the Keck School of Medicine participated in a required two-hour session on the relevance of online social media use to professionalism. Students submitted postsession written reflections about their online presence and professional roles. The authors qualitatively analyzed and coded these reflections for emerging themes. They also examined postsession evaluations and conducted a four-month follow-up survey to identify changes in students’ online social networking behaviors. Results All 180 students submitted written reflections and postsession evaluations. The authors identified 10 theme categories within three domains (immediate action, intended future action, value change) from the reflections. The most common themes were “role awareness” (144/539), “did nothing” (94/539), and “intention to edit” (84/539). On a scale of 1 to 5, students rated the overall session quality at 3.92 (standard deviation 0.28). Sixty-four percent (115/180) of the students responded to the follow-up survey. Of those, 40% (46/115) reported editing or changing their Web presence after the session, and 24% (28/115) anticipated spending less time on online social networking. Conclusions Attending a required session in a professionalism course led to thoughtful reflection, increased professional role awareness, and intention to edit and monitor future online presence among first-year medical students. After four months, students reported continued monitoring and editing of their online presence. Future studies should examine whether reinforcement throughout training is needed to maintain vigilance.

From contemporary art to core clinical skills: observation, interpretation, and meaning-making in a complex environment.

Many medical schools have incorporated experiences with representational or figurative art into the curriculum in an effort to improve learners powers of observation, visual diagnostic skills, and pattern recognition skills or to enhance communication skills, foster teamwork, and/or improve empathy. The Keck School of Medicine of the University of Southern California has partnered with Los Angeles Museum of Contemporary Art to design an educational experience with the goal of honing students abilities to observe, describe, and interpret complex information. The authors discovered that through a constructivist approach to viewing and discussing nonrepresentational, contemporary art, students were able not only to apply their observational and interpretive skills in a safe, nonclinical setting but also to accept the facts that ambiguity is inherent to art, life, and clinical experience and that there can be more than one answer to many questions. This intervention, entailing extensive guided inquiry, collaborative thinking, and process work, has allowed students and faculty to reflect on the parallel processes at work in clinical practice and art interpretation. In patient encounters, physicians (and physicians-in-training) begin with attention and observation, continue with multiple interpretations of that which they observe, move to sorting through often ambiguous evidence, proceed to collaboration within a community of observers, and finally move to consensus and direction for action. In the worlds of both art and medicine, individuals imagine experiences beyond their own and test hypotheses by integrating their own prior knowledge and intuition and by comparing their evidence with that of others.

Shaping professionalism in pre-clinical medical students: Professionalism and the practice of medicine

Background: Increasing emphasis is placed on teaching and assessment of professionalism in the continuum of medical education. Consistent and longitudinal instruction and assessment are crucial factors that learners need in order to internalize the tenets of professionalism. Aim: We aimed to develop a novel longitudinal course in professionalism spanning the first 2 years in a medical curriculum. Methods: This is a description of the process undertaken over the past 7 years to develop and implement a professionalism curriculum. We used the conceptual framework of constructivism, principles of adult learning, experiential learning and reflective practice to integrate learning with experience. We included student input in session development. Faculty mentors serve as role models to guide, assist and counsel students. Assessment of learners is accomplished using self, peer and mentor evaluation, and a student portfolio. Program evaluation is by course and faculty evaluation. Results: Students are given a final grade of pass or fail, together with a brief narrative. Course evaluations were positive. A survey questionnaire showed that more than 60% of the students reported gaining skills related to course goals. Conclusions: A longitudinal curriculum for the pre-clinical years was successfully launched. Plans are under way to expand this into the clinical years.

The Development of a Comprehensive School-Wide Simulation-Based Procedural Skills Curriculum for Medical Students

OBJECTIVEnThe purpose of this project was to assess the effectiveness of using the Delphi process to create a structured simulation-based procedural skills curriculum for all students at the Keck School of Medicine of the University of Southern California (KSOM).nnnMETHODSnThe Delphi process was used to develop a list of procedural skills that students are expected to perform competently prior to graduation. Once consensus of faculty was reached, a needs assessment was performed to poll graduating seniors experience performing each skill. A comprehensive simulation-based curriculum was developed and implemented for all Year II students at KSOM. Student satisfaction with the curriculum was collected using a standardized end-of-session evaluation form and student self confidence was assessed using a retrospective pre- and post-self-efficacy rating for each skill.nnnRESULTSnThe needs assessment clearly established the need for a more organized approach to teaching procedural skills at KSOM. Quantitative and qualitative data revealed that students responded favorably to the curriculum and appreciated the efforts put forth by KSOM. Student self-efficacy increased significantly for each skill.nnnCONCLUSIONSnThe Delphi process was effective in reaching consensus among educational leaders at KSOM regarding which skills to include in the curriculum. Although there were a few minor challenges, we determined that it is feasible to develop and implement an explicit school-wide simulated-based procedural skills curriculum.

Collaborative Commemoration: Narratives as Transactional Memorials to Heal the Wounds of War and Trauma

ABSTRACT Human beings tell stories to give voice to the indescribable, to make sense, to define themselves and their place in the world, and to convey to others a sense of their lived experience. Unlike granite or stone, war stories or poems or memoirs serve as active, enduring memorials by virtue of the reciprocal work that is required of the reader or receiver of the writing. Although a statue or edifice can symbolize a battle won or lost, or remind its viewers of lives contributed or sacrificed, and evoke collective mourning, a story or poem demands the active work of affiliation with the writer of that poem or story. This intersubjective exchange, forged through bearing witness (even if indirect), can begin the work of healing the wounds of war. Through consideration of memorial studies, trauma studies, and illness narrative theory, the author will explore the transactional nature of the collaborative commemoration that is effected by writing about the Great War. A close reading of Wilfred Owens poem Dulce et Decorum Est will serve to highlight the ways in which a narrative memorial can both evoke the trauma of war and serve as an exhortative gesture toward its healing and possible prevention.

Keck School of Medicine of the University of Southern California.

Education Policy Committee (EPC): The EPC advises the Dean and evaluates all matters related to medical education including general oversight of the curriculum and focuses on policies related to administering medical education. The EPC membership includes representatives from every clinical and basic science department, chairpersons of the Year I–II and Year III–IV Curriculum Committees, as well as student representatives. Educational deans and medical education faculty participate in an ex officio capacity. Curriculum Committees: The curriculum committees that report to the EPC are comprised of System Chairs and Discipline Coordinators (Year I–II Curriculum Committee) and Clerkship Directors, Medical Student Educators (MSE), and Basic Science representatives (Year III–IV Curriculum Committee). Students, educational deans, and medical education faculty participate in all meetings.